Individual
DR. ABRAM T COPPAGE IV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1401 RIVER RD, GREENWOOD, MS 38930-4030
(662) 459-2613
(662) 459-1159
Mailing address
PO BOX 1410, GREENWOOD, MS 38935-1410
(662) 459-2613
(662) 459-1159
Taxonomy
Speciality
Code
Description
License number
State
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
Primary
18762
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01252723
—
MS
05
—
09015650
—
MS
Enumeration date
02/08/2007
Last updated
07/08/2007
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